Department Responsibilities

(pdf) Department Statement

Information provided by the employee's supervisor to the Disability Coordinator regarding the employee's last day worked, use of sick/vacation and last day on pay. This information is necessary for the completion of a disability claim. Instructions for the supervisor are outlined in the Department Statement instructions

Family Medical Leave

The employer is required by law to designate an eligible employee's leave as Family Medical Leave. Provides leave entitlement of up to 12 work weeks for eligible employees during a calendar year.

(pdf) Return to Work or Pay Status Confirmation

This form is notification from the department to the Disability Coordinator that an employee has returned to work or pay status. This form is needed to close the active file and to inform the disability insurance company of the employee's return.

My employee has returned to work with an alternate schedule and/or restrictions, what do I do?

Contact the Vocational Rehabilitation Counselor.

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Last Modified Mar 19, 2009